Functional mapping-guided resection of low-grade gliomas in eloquent areas of the brain: improvement of long-term survival. Clinical article.

Journal of Neurosurgery
Edward F ChangMitchel S Berger

Abstract

Low-grade gliomas (LGGs) frequently infiltrate highly functional or "eloquent" brain areas. Given the lack of long-term survival data, the prognostic significance of eloquent brain tumor location and the role of functional mapping during resective surgery in presumed eloquent brain regions are unknown. We performed a retrospective analysis of 281 cases involving adults who underwent resection of a supratentorial LGG at a brain tumor referral center. Preoperative MR images were evaluated blindly for involvement of eloquent brain areas, including the sensorimotor and language cortices, and specific subcortical structures. For high-risk tumors located in presumed eloquent brain areas, long-term survival estimates were evaluated for patients who underwent intraoperative functional mapping with electrocortical stimulation and for those who did not. One hundred and seventy-four patients (62%) had high-risk LGGs that were located in presumed eloquent areas. Adjusting for other known prognostic factors, patients with tumors in areas presumed to be eloquent had worse overall and progression-free survival (OS, hazard ratio [HR] 6.1, 95% CI 2.6-14.1; PFS, HR 1.9, 95% CI 1.2-2.9; Cox proportional hazards). Confirmation of tumor overlapping...Continue Reading

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Citations

Nov 15, 2013·Clinical Neurology and Neurosurgery·Erhan TurkogluZeki Sekerci
Sep 26, 2012·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J-C TonnF W Kreth
May 10, 2011·Journal of Neurosurgery·Mitchel S Berger
Nov 26, 2011·Journal of Neurosurgery·Friedrich-Wilhelm KrethJörg-Christian Tonn
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Methods Mentioned

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imaging technique

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